Busy, busy, busy back on ward service at the big children's hospital. I like it so much better this way! I feel like I'm doing much more for these sick patients than I did for the well babies. I also like the bigger teams with more folks to talk to and interact with. My team is cool, too. Laid back, but friendly and hard-working. The pulmonary patients are interesting and as always, the acuity is interesting.

This weekend is our intern retreat. I'm excited. It's a weekend away from home, with the family in tow, and the room and board is paid for!

In the family news, my daughter wants to go to homecoming and has announced she needs a dress and high heels! :scratchchin: She's never asked to wear nice heels before and she's never much cared about school dances either. Luckily, she also announced that she and her friends decided they didn't need boys to have fun and would be going together, without dates. *phew!*

Time to start the evening tae kwon do/tennis lesson shuttle service. Need to fit in some reading inbetween as I will be having fun this weekend.

Life is good.

Our intern retreat was fantastic. :goodvibes: Not only did I have 3 days off in a row (the first day was my regularly scheduled off day for the week), but I got to hang out with my friends and family at a nice resort. The resort was very family friendly and my program even put us up in 2 rooms, one for the kids and one for me and hubby. They have a very nice pool with 2 giant slides. The kids spent the entire Saturday afternoon at the pool. I sat poolside, read a few pages of a silly book, chatted with fellow interns and enjoyed the breeze. October in Texas can be quite pleasant when it wants to.

I was a little anxious getting back to work yesterday. I had to present noon report, but that went well. Today I ran into the Neo fellow who helped me with my research paper. (Did I mention it's getting published in a few months???) We had a nice chat. Afterwards I dropped by my mentor's office just to check in and see what was new.

Finally, I dropped by our resident office and picked up the results of my inservice exam. We took this exam back in mid July, just a few weeks after starting residency. Residents take it every year. I believe it's supposed to let us and our programs know how we're doing preparing for the big board exam at the end of residency. I didn't stress too much about it at the time because I knew I wasn't expected to do all that well. Afterall, how much could they expect me to know in the first 3 weeks of training when they're testing me on board preparedness? I was told by many not to study for it anyway because the goal is to improve your score from year to year.

I was pretty nervous anyway because my 2 Step exam scores were a big disappointment for me. I was never near the top of my class in med school and didn't expect to be, but struggling to stay in the middle of the pack has bruised my ego numerous times. So, my plan was to get the printout, walk to my car and call my husband. I figured he would be able to help me adjust my mindset so the score wouldn't be too much of a blow. I hoped to get around 50%, but was genuinely afraid it could be as bad as 35-40% having never studied for it. Well, my plan didn't work because my printout was not only not in an envelope, it wasn't even folded over!

Good news is, I did better than I thought I would! I did better than average and my score was good enough that 90+% of takers with my score in the first year go on to pass the board on the first try. That just makes my day. I don't know what the average is for my class at my program and I really don't want to know. I'm just going to bask in the glory of standing up well to the rest of the country and not worry about it! :p

Tomorrow starts of week that includes 2 afternoons in clinic and 2 call nights. It's been over a month since I've done this. Let's hope I'm not too out of practice! (haha) I have a couple of nice dinners out to look forward to next week, however. Plus a good friend's wedding I will be making a regretfully brief appearance at and my boys' 12th birthdays this weekend.

Hope I'm still smiling this time next week!

This day just keeps getting better. We just got our December schedule and I have Christmas day and the day after off! :goodvibes: I also have a golden weekend the weekend before Christmas! That means both Sat & Sun off, a rarity during intern year.

I'm not exactly sure what the explanation is, but being on ward service this month has been infinitely easier and more pleasant. I'm postcall today after a 9 admit night and only a couple of hours of sleep overnight. Yet my mood has been good and call just didn't seem that bad. I got a 3-ish hour nap this afternoon and I feel relatively normal now. A couple of months ago I would have been much more tired and cranky at this point.

I'm not sure if it's that I'm more comfortable in my roll as an intern or that I like the pulmonology service more than Neuro and Heme/Onc (without a doubt!) or if it's that I stopped waking up in the wee hours of the morning to run. I'm definitely getting more sleep since I gave up the running. If only I could not gain weight along with my additional hours of sleep. I guess that battle will never end.

Anyway, my point is, I'm kinda enjoying residency right now.

Whoa, where'd the time go?

Actually, I can tell you where it went. It's been a busy month, as usual, but with a few twists.

First, I've been enjoying this month. I like the pulmonology and endocrine patients. Lots of cystic fibrosis, asthma/reactive airway, and diabetes. All of these diseases make sense to me and are, for the most part, very treatable. Even the CF kids do so much better now than they did 20 years ago. I'm treating adolescent CF patients who are graduating from HS and starting college, etc. CF is not without it's sad, sad stories, but it's not as heart-breaking as Neuro and Oncology were for me. Additionally, I really like my team. We're very different personalities, but get along very nicely. Great upper level who is very practical and pleasant to work with.

I've had more experience with the mom-in-medicine issues this month. Last Friday night I was on call and my daughter attended her first Homecoming game and dance. :laughing:

Hubby and I have started a friendly competition over healthy eating and exercise to encourage one another. It's going to last 3 months and the winner gets to spend a bonus I received for being on the ride-out team for Hurricane Ike. (something good did come of that!) The 3 months is to get me past the holiday food hump and help me get ready for the half marathon in January. I'm only in the race to complete. I need the bragging rights to motivate me to run! (haha!) Also, the amount of unhealthy food and candy sitting in front of us all the time at the hospital is ridiculous. Today the lunch was pizza and cookies and the lecturer was handing out candy to people who answered questions. Plus, there's candy at the conference tables, etc, because of Halloween. I just cannot eat that stuff and it's just a fact of life. My metabolism is that of a 38 year old with a family tendency to obesity. *shrug* I have to deal with that. So I'm bringing my lunches as much as possible, even if it's just a PB&J on wheat, yogurt and an apple.

I'm chatty today!

Hope everyone is having as good a day as I am.

I think I wrote some time back about how hard it was for me to deal with some of the critically ill patients I cared for in my first month. I don't think I got around to saying that one of those patients died a month or so ago. The unfairness of that loss is too difficult to put into words. That child was the same age as my kids and prior to the illness that took his life, was as healthy and vibrant and alive as my own children. He was uniquely talented and poised to make the most of those talents. The illness that took him was one of those horrid random things that lurks in the corners of life and sometimes makes it hard for parents to sleep at night. Like a bolt of lightening or a driver asleep at the wheel, we have no power over these things and yet they have the power to take everything from us.

It's a tragedy and there's no way around that. No words of solace. No easing of that particular pain.

And yet here we are. We continue to move forward even when the knowledge of these things looms large in our sight because to do anything else would be giving up.

The best medicine we had couldn't save that child, but it could save something like 90% of other children with similar diagnoses. That's what we as physicians live for.

He won't be my only patient to die if I go into critcial care. But he will always stay in my memory as a terribly brave and amazing young man with an amazing family and I will never forget him.

Ups and downs.

I'm sitting here at 9am in my pj's. It's my day off. I just worked 7 days straight for a total of 90+ hours. If this keeps up, I'll definitely be in violation of our work hour rules. Believe me, I wish I wasn't. I'm doing everything I can to be efficient, but this rotation is very demanding and time consuming and there is no effort made to manage our time in the hospital. We were told on day 1 to expect to be in the hospital until 5pm on every day that we aren't post-call or in clinic. We work 7 days straight with one day off between and we're q4. So that means 2 x 30hr shifts and then 3 other 10+ hour days which easily passes 90 hours a week. Well, if they give me any grief about the duty hours, they'll get my opinion on the whole thing! :p

I think it wouldn't be quite so bad if it wasn't q4 or if there was more support. We get fussed at a lot about all the little details that need to be taken care of with our mostly critical patient population (I'm in a progressive care unit, a step between ICU and regular floors with patients on vents and iNO and trachs and such). I understand and respect that this stuff needs to be done, but how am I supposed to make it all happen for 8 critical patients before 9am?

I'm venting and I probably shouldn't be, but I am. I'm exhausted, my son is having really awful trouble at school, my husband is facing a career dilemma, and all I've wanted to do the last 2 evenings is come home and cry.

Thank goodness this rotation is only 4 weeks long and will be over in about 2 1/2 weeks.

Last month I felt like super mom, making a Homecoming corsage and Halloween costumes and starting a family healthy eating and exercise plan and getting back into the swing of things. This month I feel like loser mom. :ouch:

Win some lose some, huh? Next month will be eons better and even includes a golden weekend (both days off, which only happens twice in intern year!) and a mini-vacation because I have Christmas and the day after off. I'm hoping to have my parents come and stay with us.

Well, this is probably the rotation I was dreading the most this year, so at least I'm getting through it and it'll be over and I can move on.

I've been bringing my lunch to work and packing lots of healthy food and snacks for my call nights. I've even lost a couple of pounds thanks to my "no junk food" and 5+ fruits/veggies a day commitment.

As you can probably guess, my half marathon training is in the toilet this week. :p Yes, I'm crazy. I'm just trying to run enough that I can complete the race without dying in January. It's just a way of holding onto my fitness and my hobby despite the demands of being an intern and mom. My daughter ran with me a couple of times last week, which was fantastic. Extra talk time and bonding. Always a good thing.

Now I'm debating either a nap or a trip to Old Navy to buy some flannel pj bottoms and thermal tops to lounge in on my rare days/evenings off. Comfort measures are important to doctors too!!!

Haven't been writing because I've been working so much. Well, that, and because I haven't had anything nice to say this month. :p I seriously dislike this rotation, have a personality mismatch with my upperlevel, and have been pretty much miserable every working day. I bounce back when I have a day off, only to wind up tired and pissed off again the very next day.

I did have a fantastic Saturday with my family this weekend. It was my first weekend day off this month. (and yes, still pulling 90 hr weeks) My daughter and I went and got haircuts. I got to see my son's last soccer game of the season. Finally, my husband and I went out for a very nice dinner and saw a comedian in concert. I stayed up past 1am on the day before call, but it was worth it! Laughter is the best medicine and if you can combine that with date time with the man you love, life is pretty darn great.

Too bad my mood was ruined by the end of rounds this morning. I'm sure some of it is my own lack of "getting it" with all these complicated chronically ill children. But a good piece of it is also the passive-aggressive fellow and the constant feeling of having to defend myself. Oh, and then there's having all the responsibility of patient care and none of the authority. The bane of intern year made a million times worse by the passive-aggressive fellow and the tendency to let us interns take the heat from angry consult services.

Ugh, I wasn't going to vent here, but I can't help myself. Likely a sadistic hope that the people I work with will read this and realize I'm talking about them. Not very healthy, is it? :rotfl:

Things are looking up. 6 more days on the rotation. New people to round with for the rest of those days.

But best of all, we've helped some of my sickest patients. One of my patients was smiling today for the first time since I admitted him. It just made my heart melt. Another patient is acting more and more like the school-age child that she is with each passing day. These are the kind of things that remind me why I love medicine. Making life better for a child, and thus for the family as well, is what it's all about.

And it's not even dark yet outside and I'm already home! :crossfingers:

I'm off Sunday and hubby and I have a sitter scheduled to hang out with the kids so we can spend the day together. I'll probably take the kids to a movie on Saturday afternoon when I get home from work.

*keep thinking happy thoughts*

It's finally December and I'm out of the misery that was my critical care rotation. I'm naturally inclined to make the best of things, but there really wasn't much to make the best of last month. Okay, not entirely true. I had some good and interesting patients. I worked with some families that taught me about their children. I learned more about the art of caring for complex critical patients and for patients with chronic medical problems. I learned better how to negotiate with parents who've been dealing with their child's medical issues for longer than I've been in training. I've also learned a few things about what not to do. As is always true in life, not every teacher is someone you want to emulate. Sometimes you learn what NOT to do.

I'm now in outpatient clinics at our county hospital, a lifetime away from the ivory tower and critical care. My hours are more like 8-5. So very sane! I do have a 12 hour shift in the EC on Sunday, but that's a far cry from the 30 hour shifts every 4th day.

In other news, my husband is taking a new job starting in just over a week. He's been out of the continental US for this entire week. How I hate it when he travels like this. On top of that, one of the boys has been home sick all week with Fifths disease (common childhood rash illness caused by Parvo). He's had a bad case with 5 days of fever, athralgias and myalgias. Poor kid just hurts everywhere.

This is my life isn't it? I finally get off the bad month and I've got a traveling husband and sick kid at home. :rolleyes: My inlaws have been staying with my son during the day, thank goodness. My kitchen has been a disaster this week. Dinners have consisted of mac-n-cheese, scrambled eggs and pancakes, and leftover mac-n-cheese. I still haven't slept over 7 hours a night due to my son running fevers and my tendency to still wake up at 5am.

Oh, and as a topper, I arrived nearly 30min early to work this morning because traffic was extra light and I always leave ample time for bad traffic. (I detest being late.) While sitting in my car I realized I didn't have to be at lecture until 8:30, not 8:00 like usual. Oh, and it's Grand Rounds and no one cares if I show up. So basically, I'm 2 hours early for work and already paid for parking. *SIGH*

:laughing:

I have to laugh because otherwise I might just cry this morning, more out of frustration than anything else. I need a funny movie this weekend and some TLC. I need to come down off the high pressure/high performance run I've been on and try to be more normal again. I'm still functioning as if I'm in crisis and really, I'm not.

Maybe I'll do some Christmas shopping online.